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LGBTQ + youth encounter pervasive stigma-related stress that requires effective coping skills. This study explored the coping patterns of LGBTQ+ youth participants (N = 30) in a cognitive-behavioral therapy based coping skills training. Participants, 15–18 years old with a range of gender, sexual, racial and ethnic identities, completed a coping skills inventory (A-COPE) with 12 subscales at two time points. Based on the stigma-coping framework, coping skills were broadly classified as disengagement or engagement strategies. LGBTQ+ youth were most likely to utilize avoiding problems as a strategy to cope with stress, followed closely by being humorous, relaxing and ventilating feelings. Notably, seeking professional and spiritual support were the least adopted coping strategies. Post intervention, participants reported significant increases in the areas of primary control (solving family problems) and secondary control (seeking spiritual support, seeking diversion, engaging in demanding activities and being humorous). The findings demonstrate the versatility of LGBTQ+ youth's coping strategies and show the potential of the AFFIRM intervention to promote engagement coping patterns among this population.
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Journal of Gay & Lesbian Mental Health
ISSN: 1935-9705 (Print) 1935-9713 (Online) Journal homepage:
Being humorous and seeking diversion: Promoting
healthy coping skills among LGBTQ+ youth
Shelley L. Craig, Ashley Austin & Yu-Te Huang
To cite this article: Shelley L. Craig, Ashley Austin & Yu-Te Huang (2018) Being humorous
and seeking diversion: Promoting healthy coping skills among LGBTQ+ youth, Journal of Gay &
Lesbian Mental Health, 22:1, 20-35, DOI: 10.1080/19359705.2017.1385559
To link to this article:
Accepted author version posted online: 04
Oct 2017.
Published online: 14 Nov 2017.
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, VOL. , NO. , –./..
Being humorous and seeking diversion: Promoting healthy
coping skills among LGBTQ+youth
Shelley L. Craig, PhD, LCSW a, Ashley Austin, PhD, LCSWb, and Yu-Te Huang, PhDc
aFactor-Inwentash Faculty of Social Work, University of Toronto, Ontario, Canada; bSchool of Social Work,
Barry University, Miami Shores, Florida, USA; cDepartment of Social Work and Social Administration, The
University of Hong Kong, Pok Fu Lam, Hong Kong
Received  April 
Revised  September 
Accepted  September 
Affirmative therapy; coping;
group therapy; youth
LGBTQ +youth encounter pervasive stigma-related stress that
requires eective coping skills. This study explored the coping
patterns of LGBTQ+youth participants (N=30) in a cognitive-
behavioral therapy-based coping skills training. Participants,
15–18 years old with a range of gender, sexual, racial and ethnic
identities, completed a coping skills inventory (A-COPE) with
12 subscales at two time points. Based on the stigma-coping
framework, coping skills were broadly classied as disengage-
ment or engagement strategies. LGBTQ+youth were most likely
to utilize avoiding problems as a strategy to cope with stress,
followed closely by being humorous, relaxing, and ventilating
feelings. Notably, seeking professional and spiritual support
were the least adopted coping strategies. Post-intervention,
participants reported signicant increases in the areas of primary
control (solving family problems) and secondary control (seeking
spiritual support, seeking diversion, engaging in demanding
activities, and being humorous). The ndings demonstrate the
versatility of LGBTQ+youth’s coping strategies and show the
potential of the AFFIRM intervention to promote engagement
coping patterns among this population.
LGBTQ +youth experience pervasive stigma-related stress. Although adolescence
is often a period of developmental turmoil (e.g., school pressure, home life, peer and
romantic relationships, and future uncertainty) for a vast majority of youth (Byrne,
Davenport, & Mazanov, 2007;Caseyetal.,2011), LGBTQ+youth are exposed to
pronounced health and psychosocial risks as a result of discrimination based on
their sexual orientation or gender identity (Almeida, Johnson, Corliss, Molnar, &
Azrael, 2009). Minority stress, a form of stigma-related stress, which aects those
who are part of a socially devalued group (Meyer, 1995;Miller&Kaiser,2001), is
particularly troubling for LGBTQ+youth. Minority stress contributes to an indi-
vidual’s expectation of rejection, internalized homo-/transphobia, and concealment
(Alessi, 2014;Meyer,1995,2003). Moreover, minority stressors can translate into
CONTACT Shelley L. Craig, Ph.D, LCSW University of Toronto, Factor-Inwentash
Faculty of Work  Bloor St. W., Toronto, ON MS V, Canada.
©  Taylor & FrancisGroup, LLC
structural barriers for LGBTQ+youths educational and vocational opportunities
(Barrett, Pollack, & Tilden, 2002; Pearson & Wilkinson, 2017) and access to social
and mental health services (Burgess, Lee, Tran, & van Ryn, 2008). Hatzenbuehler
(2009) posits that general psychological processes and stigma-related stress can
interact and mutually reinforce one another. These interactions negatively aect
LGBTQ+s mental health through a psychosocial pathway from stigmatized iden-
tity to mental health disparities such as depression, anxiety, and substance use.
Cumulative stressors among LGBTQ+youth, such as stigmatization, rejection, and
mental health concerns (Craig & McInroy, 2013), may require particular coping
strategies(Miller&Major,2000). The existent literature generally agrees that “cop-
ing resources” are important to health outcomes (Hunter, 1999; Perrin et al., 2004;
Safren & Heimberg, 1999), yet there is a paucity of empirical research examining
the strategies LGBTQ+youth employ to cope with discrimination and minority
stressors (McDavitt et al., 2008). The purpose of this research is to describe the
coping strategies utilized by a community-based sample of LGBTQ+youth and to
evaluate the eect of a cognitive-behavioral therapy intervention on augmenting
LGBTQ+youth coping capacity.
Coping and LGBTQ+youth
Coping, dynamic and conscious actions to regulate behavior in the face of stress,
is critical to adolescent health and well-being (Compas, Connor-Smith, Saltzman,
Thomsen, & Wadsworth, 2001). In their seminal work, Lazarus and Folkman (1984)
postulate that the coping process consists of rapidly adjusting eorts to balance
between demands and ones abilities or resources to tackle these demands. The
that are employed. Coping strategies are generally dierentiated between problem-
focused approaches, purposeful intentions to resolve tensions between the self and
the environment, and emotion-focused approaches aimed at mitigating negative
emotion invoked by stress (Compas et al., 2001).Themoremanageablestressis
(Billings & Moos, 1984;Evansetal.,2015). Compared to emotion-focused approach,
problem-focused coping is found to be more eective in reducing psychological dis-
tress (Billings & Moos, 1984;Evansetal.,2015;Lewis&Frydenberg,2002). Con-
versely, emotion-focused strategies such as acting out, withdrawal, and avoidance
may allow for temporary relief of negative emotion, but usually do little to address
the root causes of stress (Blechman & Vryan, 2000).
Coping-competence and stigma-coping theories and LGBTQ+youth
Two theories can inform our understanding of the relationship between stress
and coping for LGBTQ+youth. According to coping-competence theory, the
negative eects of stress on mental health are partly dependent on the coping
strategies employed (Blechman, 1997;Compasetal.,2001). For example, in a
study of LGBTQ+youth (n=423), negative coping strategies (e.g., internalization,
detachment, and substance use) have been identied as mediators between het-
erosexist discrimination and posttraumatic stress symptoms (Bandermann &
Szymanski, 2014). Similar outcomes were found in a study of gay and bisexual men
(Sandfort, Bakker, Schellevis, & Vanwesenbeeck, 2009). Miller and Kaiser (2001)
propose a stigma-coping framework which categorizes coping with stigma-related
stress into two broad types—engagement and disengagement coping—which
are akin to the notions of “ght” or “ight.” Viewed as inherently avoidant,
disengagement coping is employed to minimize the opportunities to encounter
stress or be confronted with stigma by keeping distance from challenging situa-
tions. On the contrary, engagement coping is active in its goal for an individual to
obtain control over stressful situations. In a recent study of children and youth (n
=227), Evans et al. (2015) found that stressful life events predicted depression.
Further, more use of disengagement and less use of engagement coping strategies
in turn contributed to heightened depressive symptoms for participants.
Engagement coping
Several studies have highlighted the importance of engagement coping for LGBTQ+
populations. Young gay men in McDavitt et al.’s (2008) study stated that when an
experience of heterosexism provoked an intense emotional reaction, they would
utilize four types of engagement coping strategies: (1) situational modication (e.g.,
avoiding the topic of sexual orientation, telling half-truths, keeping a low prole
or avoiding heterosexist environments, concealing sexual orientation, seeking ar-
mative situations, and educating others); (2) attentional deployment (e.g., paying
partial attention to a stigmatizing environment and/or dismissing provocations that
target their sexual minority status); (3) cognitive changes (e.g., reframing others
heterosexist attitudes, deconstructing the heterosexist assumptions, and reclaiming
their sense of self-reliance); and (4) response modulation (e.g., ones attempt to
transform emotion after it has been evoked, such as venting feelings, suppression,
and even substance use). Importantly, McDavitt et al.s (2008)studyfoundthat
LGBTQ+youth employed a range of strategies depending on the stigmatizing
situation and their level of distress. Primary control coping strategies such as
emotion regulation—the management of self before, during, and after an emo-
tional reaction (Gross, 1998)—can enable LGBTQ+youth to eectively manage
stigma-related stress (Hatzenbuehler, 2009;Miller&Kaiser,2001)andhavebecome
acriticaltargetofpreventionforLGBTQ+youth (Hatzenbuehler, McLaughlin, &
Nolen-Hoeksema, 2008). In a study of multiethnic sexual minorities, Choi, Han,
Paul, and Ayala (2011) found that the participants used emotional regulation as
a strategic coping strategy as they managed discrimination and avoided rejection
from their cultural communities. Excessive rumination and decit in emotion
regulation can also account for the higher rate of depression and anxiety reported
by LGBTQ+youth than heterosexual peers (Hatzenbuehler et al., 2008). Engage-
ment coping can be further broken down into primary and secondary control
coping. While primary control is aimed at proactively altering the stressful situation
by means of problem solving (e.g., initiating LGBT empowerment campaigns),
emotional regulation (e.g., regulating ones anger or resentment), and emotional
expression (e.g., expressing the feeling of frustration to friends), secondary con-
trol reects an individual’s attempt to adapt to stigma-related pressure through
distraction (e.g., engaging in recreation), cognitive restructuring (e.g., transform-
ing the unpleasant feeling to ambition to achieve success), and acceptance (e.g.,
acknowledging the prevalence of homo/transphobia).
Disengagement coping
Disengagement coping is dened as a passive or hazardous form of coping that
often precipitates internalized and externalized problems (see Compas et al., 2001,
for review). For example, self-destructive behavior, such as cutting, self-hitting, and
burning, is correlated with adolescents’ use of avoidant coping (Evans, Hawton, &
Rodham, 2005),andhasbeenknowntobeusedinresponsetoexperiencesofhomo-
phobic treatment (Fenaughty & Harre, 2003;Sornberger,Smith,Toste,&Heath,
2013). Sornberger et al. (2013) found that compared to their heterosexual peers,
bisexual and questioning youth reported greater engagement in non-suicidal self-
injury behavior (Miller & Kaiser, 2001). McDermott, Roen, and Scoureld (2008)
found that LGBTQ+youth engaged in self-destructive behavior to release their
emotional distress and avoid homophobic shaming. For example, the higher rates of
substance use among LGBTQ+youth (Marshal et al., 2008)havebeenobservedas
an approach to cope with discriminatory environments (Bandermann & Szymanski,
Disengagement strategies that are typically considered avoidant may work dif-
ferently for LGBTQ+youth. For example, the LGBTQ+youthinMcDavittetal.s
(2008) study utilized seemingly avoidant strategies (e.g., avoiding encounters with
individuals who exhibited heterosexist attitudes) in an “active and calculated” man-
ner (p. 363) where avoidance was not used as a coping strategy of last resort, but
as a result of meticulous assessment of the risk inherent in situations that may be
fraught with discrimination. Due to the stigma that they often experience from fam-
ily members, LGBTQ+youth may carefully assess the risks and benets of attend-
ing a holiday dinner and choose to avoid that event. In addition, LGBTQ+youth
to “give space” from the discrimination they experience in their external environ-
ment (Craig, McInroy, McCready, & Alaggia, 2015). The Internet, for example, has
become a venue for LGBTQ+youth to obtain emotional and informational support,
as well as to access a safe and arming online community (Craig & McInroy, 2014;
McDavitt et al., 2008). Thus, although often conceptualized as disengagement for
general youth populations (van Ingen, Utz, & Toepoel, 2016), the use of information
communication technologies (ICTs) may benet LGBTQ+whose lived experiences
may include structural discrimination and exclusion in contexts (schools, families,
policies) that are dicult for them to change.
Although coping is theorized as a process or mediator/moderator of relationships
in research identifying on the health and mental health outcomes of adolescents
(Franko, Thompson, Aenito, Barton, & Striegel-Moore, 2008;Garcia,2010), it
has been suggested that studies that measure coping as an primary outcome would
advance interventions with adolescents (Garcia, 2010). The stressors and health
disparities encountered by LGBTQ+youth necessitate interventions that focus on
understanding and modifying coping behaviors as well as social/structural stressors
(Hatzenbuehler, 2009). CBT and coping skill-based interventions, in which psycho-
logical distress and unhealthy behaviors are identied, evaluated, and altered, have
been found ecacious in enhancing LGBTQ+youthmentalhealthandcognitive
appraisal because they establish a permanent skill set to mediate current and future
stressors that impact health (Craig & Austin, 2016). Despite the emerging research
interest in the coping strategies of LGBTQ+populations, little research with youth
exists. To address these gaps, this study explored the coping strategies of LGBTQ+
youth, examined the utility of the Adolescent Coping Orientation for Problem
Experiences (A-COPE) measure for LGBTQ+youth, and evaluated the inuence
of an armative CBT-based coping skills intervention on the coping strategies of
This exploratory study of an eight-module, armative coping skills-based group
intervention (AFFIRM) was conducted in a major urban area. An earlier pilot study
detailed the results of the mental health outcomes as well as ndings related to pre-
liminary feasibility (Craig & Austin, 2016). The primary aim of the current study
is to explore changes in the coping strategies of AFFIRM participants. Institutional
Research Board approval was obtained for the study.
LGBTQ+youth were recruited using purposive sampling through an active Com-
munity Advisory Board (consisting of community-based clinicians, researchers,
and youth) and online sources such as emails and a closed Facebook group. Study
inclusion criteria included: (1) youth aged 14–18 years (upon enrollment) who iden-
tify as non-heterosexual, transgender, or gender nonconforming; (2) able to com-
municate in English; and (3) agree to participate in an eight-module intervention.
Youth were individually screened for eligibility during a short telephone or text
interview and, if eligible, completed a pre-assessment prior to the intervention.
To minimize attrition, LGBTQ+received compensation of increasing value for
study participation (T1 for $20; T2 for $30). In an eort to increase engagement
and minimize attrition, participants also received meals, snacks, and transportation
AFFIRM procedures
Developed through extensive community-based research (Austin & Craig, 2015a),
AFFIRM is an eight-module, manualized cognitive behavioral intervention created
to improve coping and reduce mental health distress. AFFIRM provides opportuni-
ties to understand and modify cognition (awareness of self and risk), mood (identi-
fying the link between thoughts and feelings), and behavior (recognizing strengths
and ways of coping) (Craig, Austin, & Alessi, 2013). During AFFIRM, skills were
identied and rehearsed within an armative context that validated youths’ iden-
tities and acknowledged stigma-based stressors. A local LGBT Community Center
provided an accessible, safe, and condential space to implement AFFIRM. Three
AFFIRM groups, each consisting of 10 youth, were conducted concurrently during
the intervention. Six co-facilitators, with experience working with LGBTQ+youth
and utilizing CBT, delivered the AFFIRM intervention. All facilitators received
approximately ve hours of training in delivering the AFFIRM intervention.
Participants (n=30) in the AFFIRM pilot intervention were between 15 and
18 years old (mean =17.07, SD =0.94) as no 14-year-olds were recruited. As noted
in Table 1 , demographic data (not mutually exclusive) included female (56.7%), male
(20%), transgender (6.7%), gender independent/non-binary (20%), and/or two-
spirit (3.3%). Sexual orientation ranged from pansexual (26.7%), lesbian (26.7%),
queer (20%), bisexual (16.7%), unsure/questioning (10%), gay (13.3%), polysexual
(6.7%), to asexual (3%). Race/ethnicity included predominately White European
Tab le  . Demographics of study participants (n=).
Variables Mean (SD) Number (Percentage)
Age . (.)
Female  (.)
Male  (.)
Tran s (.)
Non-binary gender  (.)
Two-spirit  (.)
Sexual orientation
Pansexual (.)
Lesbian  (.)
Queer  (.)
Bisexual (.)
Unsure/questioning  ()
Gay (.)
Polysexual (.)
Asexual  (.)
White European  (.)
East/South/Southeast Asian  ()
Black/African/Caribbean  (.)
Indigenous/First Nations  (.)
Latino/a (.)
(63.3%), followed by East/South/Southeast Asian (30%), Black/African/Caribbean
(26.7%), Indigenous/First Nations (26.7%), and/or Latino/a (6.7%).
Demographic measures of age, grade, gender identity, sexual orientation, and
race/ethnicity were collected at baseline. The Adolescent Coping Orientation for
Problem Experiences (A-COPE) was collected at baseline (T1) and immediately
after the intervention (T2). The A-COPE has been widely used in the coping lit-
erature as a comprehensive and reliable assessment of adolescents’ coping patterns
across emotional, behavioral, and cognitive domains (Garcia, 2010;Patterson&
McCubbin, 1987). For example, with a sample of 358 Palestinian adolescents, Tha-
bet, El Buhaisi, and Vostanis (2014) found sucient internal consistency of A-COPE
(Cronbachs alpha =.84). The A-COPE has also been suggested as a tool to evalu-
ate the outcome of clinical interventions with adolescents (Blount et al., 2008), yet
we have not found any research that utilized the A-COPE with LGBTQ+youth.
The A-COPE contains 54 items that tap into 12 dierent coping domains (ventilat-
ing feelings, seeking diversions, developing self-reliance and optimism, developing
social support, solving family problems, avoiding problems, seeking spiritual sup-
port, investing in close friends, seeking professional support, engaging in demand-
ing activity, being humorous, and relaxing). Questions such as: “Try, on y our own, to
as possible” are used. Response options ranged from 1 (never) to 5 (almost always).
In collaboration with the community advisory board, the A-COPE was slightly mod-
ied to include types of coping that were emerging in practice. Two questions were
added that included: “I go online and search the Internet; I go online to complain to my
friends.” In addition, the coping strategy of “Eat food” was moved from the subscale
of “Relaxing”to“Avoi ding P robl e ms”duetotheprevalenceofLGBTQ+youth eating
overall had sucient internal consistency (Cronbachs alpha =.87).
Data analyses
Missing data were examined for “missing at random” using the missing values anal-
ysis in SPSS. Data ranged from 0 to 3% missing on the A-COPE. The analytic plan
ing patterns; and (2) a dependent sample t-test to identify any changes in participant
Coping strategies
Participants utilized a range of coping strategies, as illustrated in Tab l e 2 .Among
all types of coping, avoiding problems was reported as the most frequent strategy
Tab le  . Means of A-COPE scale.
Subscale mean Item mean (–) SE mean
Disengagement Coping
Avoiding problems (7 items) .
Smoke . .
Drink beer, wine, liquor . .
Use drugs (not prescribed by a doctor) . .
Tell yourself that the problem is not important . .
Trytostayawayfromhomeasmuchaspossible . .
Eat food . .
Engagement Coping—Primary Control
Developing social support (6 items) .
Apologize to people . .
Talk to a friend about how you feel . .
Try to help other people solve their problems . .
Try to keep up friendships or make new friends . .
Say nice things to others . .
Cry . .
Developing self-reliance and optimism (7
Try to make your own decisions . .
Try to deal with it on your own . .
Organize your life and what you have to do . .
Go online to find answers or help. .
Try to see the good things in difficult situations . .
Try to think of good things in your life . .
Get a job or work harder at one . .
Investing in close friends (2 items) .
Be close with someone you care about . .
Be with a partner . .
Solving family problems (6 items) .
Go along with parents’request and rules . .
Try to reason with parents and talk things out;
. .
Talk to your mother about what bothers you . .
Talk to a brother/sister about how you feel . .
Do things with your family . .
Talk to your father about what bothers you . .
Seeking professional support (2 items) .
Get professional counseling (not from school) . .
Talk to a teacher or a counselor at school about
what bothers you
. .
Seeking spiritual support (2 items) .
Meditate or pray . . 
Talk to a minister/priest/rabbi . .
Engagement Coping—Secondary Control
Being humorous (2 items) .
Try to be funny and make light of it all . .
Joke and keep sense of humor . .
Relaxing (3 items) .
Listen to music—stereo, radio, etc. . .
Daydream about how you would want things to be . .
Ride around in the car . .
Ventilating feelings (7 items) .
Get angry and yell at people . .
Say mean things to people; be sarcastic . .
Go online and complain to your friends. .
Let off steam by complaining to your friends . .
Swear . .
Let off steam by complaining to family . .
(continued on next page)
Tab le  . Continued.
Subscale mean Item mean (–) SE mean
Seeking diversion (8 items) .
Sleep . .
Work on a hobby . .
Read . .
Play video games . .
Watch T V . .
Go to a movie . .
Go shopping: buy things you like . .
Use drugs prescribed by doctor . .
Engaging in demanding activities (4 items) .
Try to improve yourself (get in shape, get better
grades, etc.)
. .
Work out (jogging, biking, etc.) . .
Work hard on schoolwork or other school projects . .
Get more involved in activities at school . .
Note. denotes a new item.
(M =4.75), followed by being humorous (M =3.73), ventilating feelings (M=3.50),
developing social support (M =3.31), and investing in close friends (M =3.20).
Seeking professional (M =2.34) and spiritual (M =1.79) support were the least
used coping approaches. Specic items that were reported most frequently include:
listen to music (M =4.33); apologize to people (M =4.09); and joke and keep sense
of humor (M =3.90). The least utilized coping strategies included: talk to a minis-
ter/priest/rabbi (M =1.21); talk to your father about what bothers you (M =1.39);
and use drugs prescribed by doctor (M =1.76).
AFFIRM coping intervention eects
As evident in Table 3, there was a statistically signicant increase in the participants
use of engagement coping post-intervention. Specically, dependent sample t-test
indicated signicant increases in the areas of primary control (solving family prob-
lems, t=2.70, p<0.01) and secondary control [seeking diversion (t=4.18, p<
0.001); engaging in demanding activities (t=2.51, p<0.05), and being humorous
(t=2.51, p<0.05) and seeking spiritual support (t=2.09, p<0.05)].
This study contributes to the burgeoning research on the coping strategies uti-
lized by LGBTQ+youth. The ndings indicate that the AFFIRM intervention
shows promise to promote engagement coping and reduce reliance on less eective
strategies associated with disengagement coping. Moreover, ndings from this study
elucidate the coping experiences of LGBTQ+youth. Importantly, results on the A-
COPE from both pre- and post-test indicate that LGBTQ+youth rely on a wide
Firstly, among all types of coping, “avoiding problems” as disengagement coping
appears to be the most frequently utilized strategy. Specically, this study indicated
disengagement coping (i.e., avoiding problems or using substances) as a common
Tab le  . Dependent-sample T-test of A-COPE scale.
No. of Pre-test score Post-test score
Variables (number of items) Items Mean SD SE mean Mean SD SE mean t-value
Disengagement Coping
Avoiding problem . . . . . . .
Engagement Coping—Primary
Solving family problems . . . . . . .∗∗
Seeking professional support . . . . . . .
Developing self-reliance and
. . . . . . .
Developing social support . . . . . . .
Seeking spiritual support . . . . . .
Investing in close friends . . . . . . .
Engagement Coping—Secondary
Ventilating feelings . . . . . . .
Seeking diversion . . . . . . .∗∗∗
Engaging in demanding
. . . . . . .
Being humorous . . . . . . .
Relaxing . . . . . . .
Total Coping Score . . . . . . .∗∗∗
Note. p<., ∗∗p<., ∗∗∗ p<..
coping strategy utilized by LGBTQ+youth, and there was no signicant change
post-intervention. It is important to consider the unique minority stressors and
social, familial, and cultural contexts of LGBTQ+youth when drawing conclusions
about the utility of the specic strategies of LGBTQ+youth. It is possible that cer-
tain avoidance strategies, such as keeping distance from prejudicial situations (e.g.,
staying away from homophobic peers or withdrawing from a stressful situation),
denying discriminatory experiences (e.g., redening hatred words to be unrelated to
sexual orientation), or wishful thinking (e.g., hoping someone will stand up against
the homophobic environment), may be eective for coping during adolescence as
youths’ hostile contexts (e.g., homo-/transphobic schools, families, communities)
Our ndings about coping through the use of substances is consistent with exis-
tent research that has noted that LGBTQ+youth frequently utilize substances when
under stress (Austin & Craig, 2013;Marshalletal.,2008). As such, it may be partic-
ularly important to tune into the role of minority stressors in the lives of LGBTQ+
youth with substance use issues. Moreover, LGBTQ+with high levels of stress may
need targeted interventions which help them to identify coping strategies to replace
substance use as a way to cope with their painful emotions and often less than opti-
mal circumstances.
Participants also utilized a host of engagement strategies. Compared to the
nding in McDavitt et al.s (2008)studythatLGBTQ+youth shy away from involve-
ment in family issues, our participants utilized the primary control coping strat-
egy of solving family problems. This includes following parents’ requests and rules
while also trying to reason with them and seek compromise. The LGBTQ+youth
in this study communicated more with their mothers and siblings than their fathers
to solve family problems (Green, 2000;Savin-Williams,2003). Similarly, emerging
research has found that for some ethnoracial lesbian and bisexual girls, educating
their family members about LGBT issues is a source of resilience and coping (Craig,
Austin, Alessi, McInroy, & Keane, 2017). Therefore, interventions aimed to enhance
LGBTQ+youth resilience should not regard LGBTQ+youthonlyaspassivevic-
tims in their families, but rather support LGBTQ+in their eorts to advocate for
themselves within their families as a healthy coping strategy (Mallon, 2005).
LGBTQ+youth also utilized the secondary control coping strategies of seeking
diversion, engaging in demanding activities, and being humorous. Seeking diversion
is commonly utilized by adolescents in the face of stress (de Anda et al., 1997). In
this study, sleeping and working on a hobby were frequently utilized by LGBTQ+
youth. Engaging in demanding activities, such as trying to improve yourself and
organize your life and what you need to do, is a way to cognitively engage in being
resilient. Humor stands out as another prominent secondary control coping strat-
egy that LGBTQ+youth employ. This nding is consistent with results from adult
through dicult situations (Christman, 2012). Humor may be particularly useful
for LGBTQ+youth faced with cumulative stress, as Abel (2002) found that adoles-
cents who have greater sense of humor report lower levels of stress, less anxiety, and
greater use of positive appraisal and problem-solving coping strategies.
In this study, many aspects of engagement coping (e.g., developing self-reliance
and optimism, ventilating feelings, and relaxing) tap into emotion regulation; these
ndings make sense, given the key role of emotional regulation in healthy adoles-
cent adjustment (Silk, Steinberg, & Morris, 2003). Emotion regulation, according to
Thompson (1994), is dened as a process where an individual understands, eval-
uates, and modies emotional responses under a stressful circumstance. Emotion
regulation decit, such as poor emotion awareness and excessive rumination, has
been identied as a determinant of poor adolescent mental health (Cicchetti & Toth,
2005;Silketal.,2003). Hatzenbuehler et al. (2008)foundthatforLGBTQ+youth,
emotion regulation decit can function as a mediator between minority stressors
and internalizing symptomatology and contribute to psychological distress.
Importantly, the engagement coping of AFFIRM participants increased from pre-
to post-intervention. Stated in another way, LGBTQ+developed more produc-
tive coping strategies to deal with identity-related stress through participation in
AFFIRM. In particular, AFFIRM appears to increase the primary control engage-
ment coping strategy of solving family problems and secondary control coping strate-
gies, which included seeking diversion, engaging in demanding activities,andbeing
humorous. Similarly, Steinhardt and Dolbier (2008)foundthataCBTinterven-
tion promoted resilience, problem solving, and positive reframing, and reduced the
avoidant coping and psychological symptoms of college students. Frydenberg et al.
(2004) also found that helping youth think concretely about their coping mecha-
nisms allows them to incorporate new approaches to managing stress. Existing evi-
dence (Austin & Craig, 2015b; Gordon, Tonge, & Melvin, 2011)alsosupportsthe
potential of using a CBT-based approach to arm LGBTQ+identities which may
be an important component of mobilizing engagement coping skills. Further, nd-
ings of the present study note the potential importance of targeting coping as an out-
come variable within interventions designed to reduce psychological distress among
It is essential to contextualize these emergent ndings with those coping strategies
reported less frequently. Participants reported low levels of seeking professional or
spiritual support. This is consistent with research conducted by Burgess et al. (2008),
who found that LGBTQ+youth do not use formal counseling services because
of real and/or perceived experiences of homophobic discrimination within social
service and mental health systems. A lack of relevant, accessible, and LGBTQ+
armative programs may be related to the underutilization of professional sup-
port by LGBTQ+youth (Gridley et al., 2016; Richardson, Stallard, & Velleman,
2010). Understanding and subsequently targeting the types of coping that LGBTQ+
youth utilize and tailoring services to meet their needs may enhance mental health
This pilot study had several limitations. Given the small sample size and lack of
comparison group, research ndings should be interpreted with caution. The small
numbers may restrict the statistical power of this study in detecting meaningful dif-
ferences between pre- and post-intervention scores. Evaluating outcomes using a
randomized control trial with multiple follow-up periods in future research would
enable researchers to examine long-term treatment eects between LGBTQ+iden-
tities. Further studies should also use a variety of coping measures as outcomes.
Despite these challenges, this pilot study illuminates some commonly used cop-
ing strategies by LGBTQ+youth.Whileouranalysisfoundthepost-intervention
increase in participants’ being humorous, future studies may explore the frequency
and nature of the humor coping response for LGBTQ+youth. Understanding the
stressors and resultant coping strategies could enable services that enhance the cop-
ing toolbox of LGBTQ+youth and contribute to their resilience.
Conclusions and clinical implications
This study provides valuable insight regarding coping strategies employed by
LGBTQ+and the positive impact of a coping skills group intervention on youths
coping approaches. Findings from this study provide valuable insight for clinicians.
The impact of minority stress on the lives of LGBTQ+necessitates a focus on
enhancing and building coping skills throughout clinical interactions. Clinicians
should utilize a comprehensive approach to understand and aid the development
of a range of coping strategies for LGBTQ+youth that is grounded in their daily
realities. The post-intervention increases in engagement coping suggest that CBT-
based coping interventions may have particular promise to impact active coping
strategies such as problem solving and self-improvement. Integrating clinical
approaches that encourage LGBTQ+youth to reect on their abilities to solve
problems and manage stress eectively while arming the utility of the use of
humor to buer the eects of stress is an important consideration with this pop-
ulation. Such a tangible approach allows youth to evaluate their present coping
strategies and “test out” new skills. The results of this study underscore the impor-
tance of clinical practice and research focused on understanding and enhancing
coping among LGBTQ+youth.
The authors thank the thoughtful members of the AFFIRM Council Community Advisory Board
for their support and advice, Sandra D’Souza for brilliant data support, and the inspirational
youth who participated in this study.
This work was supported by the Institute of Infection and Immunity (Grant ID 72045249).
The authors have no conicts of interest to report.
Shelley L. Craig, PhD, LCSW
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puter Review,34(5), 511–529. doi:10.1177/0894439315600322
... While discrimination against their sexual and/ or gender minority identities presents unique challenges to them, SGMY also have access to unique protective factors that may facilitate resilience. For example, SGMY have been found to have high rates of primary and secondary coping strategies such as problem solving, using humor (Craig et al., 2018), and feeling particularly connected to their peers due to their minority status (Meyer, 2015). Social support is an important component of resilience for SGMY and has been linked to improved well-being (Asakura, 2010; Thoits, 2011). ...
... Such self-harming behaviors in youth and adolescents have been found to cause negative outcomes (such as chronic addiction and severe mental illness) in later adulthood (Moran et al., 2015). This finding also mirrors research that has identified a range of effective problem-solving skills employed by SGMY, even when encountering discrimination (Craig et al., 2018). These results highlight the distinctions in the facilitators of resilience for SGMY and suggest that external factors contribute differently than with general youth populations. ...
This study explores the relevance of the brief Child and Youth Resilience Measure (CYRM-12) for sexual and gender minority youth (SGMY) aged 14–23 (N = 4,810), compares their patterns of resilience with general youth populations, and explores distinctions between key subgroups of SGMY. SGMY reported significantly lower scores, indicating poorer outcomes, than non-SGMY in several CYRM-12 items, especially those addressing familial and community support. Older SGMY (aged 19–23) reported significantly higher CYRM-12 scores than younger SGMY (aged 14–18; t = 11.00, p < .001). Compared with their non-SGMY counterparts, SGMY reported significantly lower scores regarding supportive parental relationships, connection to offline community, and school belongingness yet reported higher scores regarding the importance of education. Three factors contributed to SGMY resilience: (1) peer and community belonging, (2) familial and cultural support, and (3) youth’s personal attributes and self-efficacy. The results of this study also suggest that measuring resilience in SGMY should incorporate online as well as offline sources. Recommendations to enhance the CYRM-12 to capture the experiences of SGMY for social work research and practice are provided.
... Adaptive strategies such as acceptance and seeking help could be promoted, while the negative effects of maladaptive strategies such as lack of self-acceptance and isolation could be identified, and subsequently individuals could be made aware of its negative effects. Interventions aiming to promote adaptive coping strategies have a proven positive effect on mental health outcomes [59,60]. Austin and Craig have developed the AFFIRM module, a cognitive behavioral intervention developed to improve adaptive coping and decrease mental health problems for sexual and gender minority youth [61]. ...
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Background: Gender-affirming treatments are reported to improve mental health significantly. However, a substantial number of transgender individuals report a relapse in, or persistence of, mental health problems following gender-affirming treatments. This is due to multiple stressors occurring during this period, and in general as a consequence of widespread stigma and minority stress. Aim: The aim of this pilot study was to identify different coping strategies that transgender individuals use in response to stressors prior to and following gender-affirming treatments, as mediator of mental health. Methods: Qualitative interviews were conducted to better understand the treatment outcomes and healthcare experiences of Dutch transgender individuals who had received gender-affirming treatments. Nineteen participants were included, of which 12 identified as (transgender) male, six as (transgender) female and one as transgender. Outcomes: Inductive coding and theory-informed thematic analysis were used to assess stressors (ncodes = 335) and coping strategies (ncodes = 869). Results: Four stressor domains were identified, including lack of support system, stressors related to transition, and physical and psychosocial stressors post-transition. We identified six adaptive coping strategies of which acceptance, help seeking and adaptive cognitions concerning gender and transition were reported most frequently. Of the seven maladaptive strategies that we identified, social isolation and maladaptive cognitions concerning gender and transition were the most-reported maladaptive coping strategies Clinical implications: The results indicated that transgender individuals may experience significant stress, both transgender-specific and non-specific, prior to and following gender-affirming treatments and, as a result, use many coping strategies to adapt. Increased awareness of stressors and (mal)adaptive coping strategies may help to improve mental healthcare and overall support for transgender individuals. Strengths and Limitations: This is the first (pilot) study to provide insight into the range of stressors that transgender individuals experience during and after gender-affirming treatments, as well as the variety of coping strategies that are used to adapt. However, since this was a pilot study assumptions and generalizations of the evidence should be made cautiously. Conclusion: Results of this pilot study showed that transgender individuals may undergo significant stress during and after gender-affirming medical treatment related to the treatments and the social experiences that occur during this period, and as a result, use a range of coping strategies to adapt to the stress.
... Among the 12 studies with a combination of TGNB and non-TGNB participants and with no separated outcome data for the TGNB subsample (Craig, Austin, & McInroy, 2014;Craig, Austin, & Huang, 2018;Craig, Eaton, et al., 2021;Goldbach, Rhoades, Mamey, et al., 2021;Goldbach, Rhoades, Rusow, & Karys, 2021;Hilgeman, Lange, Bishop, & Cramer, 2022;Lange, Hilgeman, Portz, Intoccia, & Cramer, 2020;Pachankis, McConocha, et al., 2020;Pachankis, Williams, et al., 2020;Riggle, Gonzalez, Rostosky, & Black, 2014;Russon, Morrissey, Dellinger, Jin, & Diamond, 2021;see Tables 4, 5, and 6), sample sizes ranged between 30 and 263 (Craig et al., 2014) at baseline. Four of these studies had sample sizes larger than 100 (Craig et al., 2014;Craig, Eaton, et al., 2021;Pachankis, Williams, et al., 2020). ...
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Research suggests that transgender and non-binary (TGNB) individuals experience lower levels of psychological well-being than the general population. Although practice recommendations and guidelines exist, there is a paucity of studies evaluating the effects of psychological interventions on this group. This systematic review aimed to synthesize and analyze existing empirical affirmative psychological interventions for TGNB individuals to assess their efficacy. Eight databases (PubMed, Web of Science, PsycINFO, Scopus, LILACS, Cochrane, ProQuest, Google Scholar) were searched from January 2010 to June 2022 to identify relevant studies. Included studies needed to be randomized controlled trials, quasi-experimental, or uncontrolled pre-post. Twenty-two articles were included, of which eight had TGNB participants only, two had mixed samples with separated outcome data for TGNB participants, and 12 had mixed samples with no disaggregated data. Experimental designs, participant samples, assessed variables, and type of interventions varied widely across studies, thus preventing comparisons. Overall results suggest improvements in psychological distress, depression, anxiety, suicidality, substance-related risk behaviors, coping skills/emotion regulation, stress appraisal, self-esteem, self-acceptance, social support, minority stress, resilience, hope, positive identity, and identity acceptance, although conclusions are limited by moderate-to-high risk of bias. Future research should implement more consistent and rigorous methodological designs to assess and compare intervention efficacy.
... Humour has been identified as a way of dealing with adversity, as it allows the transformation of serious and unpredictable life circumstances into less serious and more controlled ideas (Martin, 2007), and has been highlighted within the LGBT community to improve coping and reduce mental health distress in individuals (Craig et al., 2018;McGuinness, 2018;Willard, 2010). However, it must be stressed that this method of support is especially relevant to the self (and potentially LGBT others), and may not transfer to offers of support from others, and Willard highlights that non-LGBT individuals should 'exercise caution when using humour in order to avoid hurting others' (p.2). ...
Aims: The negative school experiences of transgender students are well documented, but so far little research has explored what is going well for transgender students in school. This research highlights some of the positive school experiences of transgender youth in order to promote positive change. Methods: A qualitative, interpretive approach was adopted. An initial focus group explored language within the transgender community and helped to design questions for semi-structured interviews. Interviews were then conducted with three transgender young people. An Interpretative Phenomenological Analysis approach was adopted. Findings: Five superordinate themes emerged from the participants' narratives. The Importance of Language was highlighted as a means for transgender youth to assert their own identities and for others to demonstrate respect, and Individual Teacher Support, Whole-School Approaches and The Importance of Community highlighted ways others have shown support to transgender youth. A final theme, My Own Best Friend, reflected the skills and resilience of the transgender young people themselves. Limitations: Limitations are associated with the challenges of using a qualitative, interpretive approach, including language and the role of the researcher. These are discussed alongside suggestions for development. Conclusions: The research findings highlight that transgender young people are able and willing to share their experiences and highlight positive practice in schools. Educational psychologists are uniquely positioned to support young people at an individual and systemic level. It is important that they continue to support transgender young people, as well as to continue helping schools and local authorities to develop guidelines for supporting transgender students.
... The theory generated in this study provides a practical way of thinking about how the impact of structural stigma can be mediated in healthcare settings. Survival for those who experience overlapping stigmas that whose survival apparatus is routinely engaged may be more about getting through day to day living, which precludes individuals from engaging in futureoriented health-seeking behaviour because delaying and avoiding access to health care out of fear of discrimination presents itself as a better option than accessing health services (Craig et al., 2018;Dubreucq et al., 2021;Ecker & Lykins, 2021;Gu et al., 2021;Massaroni et al., 2022;Partow et al., 2021;Rodriguez-Hart et al., 2021;Subu et al., 2021;Yassin et al., 2021;Yu et al., 2021). If stigma was worked through in ways that disrupted the reproduction of hegemonic power relations and transformed social structures in ways that brought about equitable change, then its impact could be mitigated by engaging in broadly inclusive practices that intervened upon stigma. ...
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This study was designed to generate theory that works to further understandings of the processes and factors influencing the conditions under which primary care services are delivered to diverse 2SLGBTQ populations in Nova Scotia. This Constructivist Grounded Theory study employed Intersectional and Critical lenses, complicated the notion of identity in a broadly inclusive manner, and gained insight into socio-structural factors that influence access to health services in primary care settings across Nova Scotia. By conducting a preliminary literature review, stigma was identified as significant to the health outcomes of 2SLGBTQ populations, justifying its use as a starting point for the investigation. Upon REB approval, a diverse sample population was recruited; variation was maximized across categories of identity (sexual orientation, gender, race, (dis)ability, and citizenship), geographies, and professional scope of practice/role. Sampling purposively from historically underrepresented groups so they were overrepresented in the sample population created points of comparison for the purpose of enhancing data analysis and generation of a robust grounded theory. The sample population (n=30) was comprised of three subgroups: 2SLGBTQ health service users (HSUs) (n=10), 2SLGBTQ health service providers (HSPs) (n=10), and non-2SLGBTQ HSPs (n=10). Semi-structured interviews lasting up to 90 minutes were conducted with each participant using video-conferencing software. Participants confirmed that stigma was a meaningful construct; its significance was substantiated throughout the data collection process. Conceiving stigma as a socio-structural process that determines health outcomes allowed for an exploration of 2SLGBTQ stigmatization in health care by investigating the delivery of primary care services to 2SLGBTQ populations across a provincial health system. Data analysis started with its collection by way of constant comparison, and continued through coding methods, memo-writing, diagramming, and writing this dissertation. As such, the level of abstraction was raised and a substantive theory of Working Through Stigma was co-created. The main concern of participants was that stigma causes individuals to experience power relations differently and the experiences of those with relatively less power are often disproportionately negative. The theory depicts what participants are doing about their concerns and involves three interrelated processes: depending on context, resolving histories, and surviving the situation.
The stress literature suggests that coping strategies are implicated in mental health outcomes. However, the longitudinal relationship between coping strategies and mental health in the autistic adult population has not yet been examined. This 2-year longitudinal study examined the predictive role of both baseline and change in coping strategy use over time (i.e., an increase or decrease) on anxiety, depression, and well-being after 2-years in 87 autistic adults aged 16 to 80 years. Controlling for baseline mental health, both baseline and increase in disengagement coping strategies (e.g., denial, self-blame) predicted higher anxiety and depression, and lower well-being, while an increase in engagement coping strategies (e.g., problem solving, acceptance) predicted higher well-being. These findings extend the current coping literature in autistic adults, offering insight into mental health support and intervention options.
Objective Religiosity/spirituality confer protective mental health benefits in adolescents, although the relationship between the two in transgender youths is unclear. This systematic review of the literature sought to clarify this relationship. Method We searched five databases for quantitative and qualitative studies exploring the relationship between religiosity/spirituality and mental health in transgender youths. Results Eighteen articles met criteria. Six showed a negative relationship between religion/spirituality and mental health, seven showed a mixed relationship, two showed a positive relationship, and three showed a neutral relationship. Only four studies exclusively evaluated transgender youths’ experiences of religiosity/spirituality and mental health. The 14 other studies more broadly evaluated the experiences of LGBTQ youths, where participation among transgendered adolescents was low. Twelve studies were cross-sectional cohort studies, while six were qualitative studies. Conclusion The relationship between religiosity/spirituality and mental health in adolescents identifying as transgender is complex. Quantitative studies were mixed regarding the association between religion/spirituality and mental health. Qualitative studies showed a more nuanced relationship between the two in which religiously motivated stigma from parents or communities resulted in worsened mental health outcomes, while intrinsic religiosity appeared to correspond to improved psychological well-being. Implications of these findings for mental health providers and religious leaders are described.
Cognitive Behaviour Therapy is regarded as one of the most effective intervention modalities for a wide range of mental health concerns. This article explores the potential of combining CBT approaches with queer affirmative practices. In section one, the authors present a content review of forty-four articles on affirmative CBT worldwide, to assess how CBT can be effectively used with LGBTQIA+ individuals, how CBT can be beneficial for LGBTQIA+ individuals and how can CBT be modified to make it queer affirmative. In section two, the authors describe experiences in adapting QA-CBT to the Indian context in individual and group therapy, and present suggestions for making this practice intersectional.
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Robust population-based research has established that sexual and gender minority youths (SGMYs) are at an increased risk of mental ill-health, but there is a dearth of literature that seeks to explore how to best support SGMY mental wellbeing. This scoping review aims to identify findings related to coping strategies and/or interventions for building resilience and/or enhancing the mental wellbeing of SGMYs. PRISMA extension for scoping review (PRISMA-ScR) guidelines was utilized for this review. Studies were included if they were peer-reviewed papers containing primary data; reported psycho-social coping strategies for SGMY; were conducted with SGMYs in the adolescent age range; and were published in English. MEDLINE, Embase, and PsycINFO databases were searched. Of the 3692 papers initially identified, 68 papers were included with 24 intervention-focused studies of 17 unique interventions found. The most commonly cited therapeutic modality was cognitive behavioral therapy (CBT) (n = 11 studies). Despite the need to support the mental wellbeing of SGMYs, few interventions focused on this area and unique populations have been reported upon in the peer-reviewed literature. As a result, there is considerable potential to develop supports for SGMYs.
This meta-narrative review on mental health early intervention support for LGBTQ+ youth aimed to develop a theoretical framework to explain effective mental health support. Using the RAMESES standards for meta-narrative reviews, we identified studies from database searches and citation-tracking. Data extraction and synthesis was conducted through conceptual coding in Atlas.ti. in two stages: 1) conceptual mapping of the meta-narratives; 2) comparing the key concepts across the meta-narratives to produce a theoretical framework. In total, 2951 titles and abstracts were screened and 200 full papers reviewed. 88 studies were included in the final review. Stage 1 synthesis identified three meta-narratives - psychological, psycho-social, and social/youth work. Stage 2 synthesis resulted in a non-pathological theoretical framework for mental health support that acknowledged the intersectional aspects of LGBTQ+ youth lives, and placed youth at the centre of their own mental health care. The study of LGBTQ+ youth mental health has largely occurred independently across a range of disciplines such as psychology, sociology, public health, social work and youth studies. The interdisciplinary theoretical framework produced indicates that effective early intervention mental health support for LGBTQ+ youth must prioritise addressing normative environments that marginalises youth, LGBTQ+ identities and mental health problems.
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This study used a focus group methodology to explore the experiences of stress and coping among 40 Hispanic, Caribbean Black, Haitian, and African American cisgender sexual minority girls living in the southeastern United States. An analysis of the data using grounded theory strategies revealed that participants were part of a cultural context in which few boundaries existed between family, religion, and culture, and that they tended to believe that they were betraying family and culture because of their sexual minority identities. Participants described (a) real or perceived transgressions of gender expectations and roles, (b) violating religious doctrine, and (c) emotional exclusion and taunting by family members. In the same context, the theme of HERoic Coping described participants’ resilience that manifested as (a) serving as the family educator, (b) being “out” in the open with family, and (c) creating safety. This study found that the negotiation of complex family, religious, and community environments is critical to understanding resilience in ethnoracial sexual minority girls.
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Purpose: Few transgender youth eligible for gender-affirming treatments actually receive them. Multidisciplinary gender clinics improve access and care coordination but are rare. Although experts support use of pubertal blockers and cross-sex hormones for youth who meet criteria, these are uncommonly offered. This study's aim was to understand barriers that transgender youth and their caregivers face in accessing gender-affirming health care. Methods: Transgender youth (age 14-22 years) and caregivers of transgender youth were recruited from Seattle-based clinics, and readerships from a blog and support group listserv. Through individual interviews, focus groups, or an online survey, participants described their experiences accessing gender-affirming health care. We then used theoretical thematic analysis to analyze data. Results: Sixty-five participants (15 youth, 50 caregivers) described barriers spanning six themes: (1) few accessible pediatric providers are trained in gender-affirming health care; (2) lack of consistently applied protocols; (3) inconsistent use of chosen name/pronoun; (4) uncoordinated care and gatekeeping; (5) limited/delayed access to pubertal blockers and cross-sex hormones; and (6) insurance exclusions. Conclusions: This is the first study aimed at understanding perceived barriers to care among transgender youth and their caregivers. Themed barriers to care led to the following recommendations: (1) mandatory training on gender-affirming health care and cultural humility for providers/staff; (2) development of protocols for the care of young transgender patients, as well as roadmaps for families; (3) asking and recording of chosen name/pronoun; (4) increased number of multidisciplinary gender clinics; (5) providing cross-sex hormones at an age that permits peer-congruent development; and (6) designating a navigator for transgender patients in clinics.
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This article explores how individuals use online coping strategies after experiencing a negative life event. Many studies have shown that online coping is of rising importance. However, these studies have not provided all pieces of the puzzle because they tend to focus on one particular online venue (e.g., an online support group or social network site [SNS]) and on a limited number of coping strategies. This article aims to provide a more complete picture, by simultaneously examining multiple online and off-line coping strategies, using a survey administered to a representative sample of the 16+ population of the Netherlands. Furthermore, we analyze what kind of Internet activities are related to online coping and whether online coping is associated with well-being. Some 57% of our sample mentioned some form of online coping. Using the Internet for mental disengagement, active coping and planning were the most reported online coping strategies, whereas strategies aimed at emotional coping were reported less frequently. Online coping encompassed several activities: online gaming, which was associated with mental disengagement; searching for information, which was associated with problem-focused coping; and SNS and online support groups, which were associated with mental disengagement, problem-focused coping, and socioemotional coping. Finally, we examined the correlations between online coping and well-being. Controlling for off-line coping, we found online mental disengagement and online socioemotional coping to be inversely related to life satisfaction, self-esteem, and optimism, whereas correlations between online problem-focused coping and well-being were nonsignificant. The implications of these findings are discussed.
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Lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth have the potential for considerable resilience. Positive media representations may mediate negative experiences and foster self-esteem, yet the relationship between resilience and both traditional offline and new online media remains underaddressed for this population. This grounded-theory exploration of media-based resilience-building activities by LGBTQ youth (n = 19) indicated four themes that media use enabled: coping through escapism; feeling stronger; fighting back; and finding and fostering community. Data are embedded to evidence thematic findings and incorporate participant voices. The importance of considering the media within contemporary LGBTQ youth's ecological framework to capture their resilience is considered.
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When empirically supported treatments (ESTs) are effectively adapted for use with minority populations, they may be more efficacious. As such, there is a need to adapt existing ESTs for use with diverse sexual and gender minority youth (SGMY). The unique bias-based challenges faced by SGMY require the integration of affirmative practices into ESTs to effectively address the specific needs of this underserved group of youth. The primary purpose of the authors in this article is to present a clearly articulated stakeholder driven model for developing an affirmative adapted version of cognitive behavioral therapy (CBT) for use with diverse SGMY. The authors' approach to adaptation follows the "adapt and evaluate" framework for enhancing cultural congruence of interventions for minority groups. A community based participatory research approach, consistent with a stakeholder driven process, is utilized to develop the intervention from the ground up through the voices of the target community. Researchers conducted 3 focus groups with culturally diverse SGMY to explore salient aspects of youths' cultural and SGM identities in order to inform the intervention and ensure its applicability to a wide range of SGMY. Focus group data is analyzed and integrated into an existing group-based CBT intervention. The following themes emerge as critical to affirmative work with diverse SGMY: (1) the interplay between cultural norms, gender norms, sexual orientation, and gender identity; (2) the complex role of religious community within the lives of SGMY; and (3) consideration of extended family and cultural community as youth navigate their SGM identities.
Research finds lower levels of academic performance among sexual minority high school students, but some studies suggest sexual minorities have higher levels of educational attainment in adulthood. To further our understanding of how and why sexual orientation is associated with educational success, this study turns attention to the pathways to college completion, examining points along educational trajectories in which sexual minorities fall behind or surpass their heterosexual peers. Using data from the National Longitudinal Study of Adolescent to Adult Health, we find that sexual minority women are less likely than women with no same-sex sexuality to complete college, in part due to their high school performance and transition into college. Men who experience same-sex sexuality only in adolescence struggle in high school, but men who experience same-sex sexuality for the first time in adulthood are more likely to earn a college degree than men who do not experience same-sex sexuality.
This pilot study sought to evaluate the feasibility and effectiveness of a brief, eight module affirmative cognitive behavioral coping skills group intervention (AFFIRM) with sexual and gender minority youth (SGMY) developed through community partnerships. A diverse sample of SGMY (n = 30) participated in the AFFIRM pilot and completed reliable measures of depression, reflective coping, and stress appraisal at three time points. Over the study duration, significant reductions were found in depression and appraising stress as a threat. Significant increases were found in reflective coping and perceiving stress as a challenge. Participants found the intervention to be valuable and reported high levels of acceptability and skills acquisition. These promising findings suggest that AFFIRM has potential effectiveness as a community-based intervention for SGMY. Implications for practice and research are provided.
Recently, scholars have begun to advocate that categories of traumatic events be expanded to include experiences that do not meet the traditional diagnostic criteria for posttraumatic stress disorder (PTSD), such as oppression. Our study builds on this work by examining experiences with 2 kinds of heterosexist oppression: 1 that meets the traditional diagnostic criteria for PTSD (i.e., sexual orientation-based hate crime victimization) and 1 that does not (i.e., heterosexist discrimination), as predictors of PTSD symptoms in a sample of 423 lesbian, gay, and bisexual persons who responded to an online survey. In addition, we examined the mediating roles of coping with heterosexism via internalization, detachment, and drug and alcohol use in the heterosexist oppression-PTSD symptoms link. Results indicated that when examined concurrently, both sexual orientation-based hate crime victimization and heterosexist discrimination had direct and unique links to PTSD symptoms. In addition, the results of the mediational analysis using bootstrapping provided support for a theorized model in which coping with oppressive events via internalization, detachment, and drug and alcohol use mediated the link between heterosexist discrimination and PTSD symptoms but not between sexual orientation-based hate crime victimization and PTSD symptoms. Finally, the 5 variables in the model accounted for 42% of the variance in PTSD scores.